The 2024 Indiana Legislative Session is Underway!

Dear Advocates,

As the Indiana Legislative Session began on January 8th, 2024, we invite you to follow along as we navigate this year's legislative session. If you are interested in learning more about our policy agenda, please be sure to review our Public Policy Statements HERE.

At Mental Health America of Indiana, our mission is to deliver impactful legislation to our valued stakeholders and advocates, ultimately driving transformation within Indiana's behavioral health sector. Below, you will find essential details on how you can actively support our advocacy efforts at the Indiana Statehouse this year!

We plan to stay in touch with you through technology, so please be sure to sign up for our IN.session Newsletter and VoterVoice Action Alerts that you can find below to stay up to date on important behavioral health related legislation.

A few behavioral health bills have already been introduced and heard in committee, you can learn more below.

Bills heard in the House:

House Bill 1216: MEDICAL SERVICES FOR CERTAIN DETAINEES (Steuerwald, G) - The bill removes certain provisions from current law that specify that medical services provided to an individual who is involuntarily committed to a facility for mental health services are considered medically necessary when they align with generally accepted clinical care guidelines.

1. It mandates Medicaid reimbursement for services that are required to be covered by the Office of the Secretary of Family and Social Services when provided to an eligible individual who is involuntarily committed to a mental health facility.
2. The bill also amends the requirements for an application for detention in cases of mental health or substance use disorders.
3. This legislation is effective immediately upon its passage.

This bill seeks to ensure that medical services for individuals detained in mental health facilities are covered by Medicaid and removes certain criteria for determining the medical necessity of these services. It also addresses the process of detention for individuals with mental health or substance use disorders.

yeas 11, nays 0.

House Bill 1260: INDIANA DEPARTMENT OF HEALTH (Barrett, B) - This bill addresses various matters related to healthcare and administrative processes in Indiana. Here's a summary of its key points:

1. It specifies that laws governing administrative proceedings apply to the Indiana Department of Health, particularly concerning the involuntary transfer or discharge of residents from health facilities.
2. The bill sets the fee amount for services provided by the state health laboratory based on either the federal Medicare reimbursement rate or the Medicaid reimbursement rate, depending on the service.
3. It updates the list of crimes or acts that disqualify individuals from employment as home health aides, nurse aides, or other unlicensed employees at home health agencies and certain healthcare facilities.
4. The state department is required to investigate reports of nurse aides or home health aides convicted of certain crimes and remove them from the state nurse aide registry following an administrative hearing.
5. It makes it a Class A infraction for individuals convicted of certain crimes to knowingly or intentionally apply for jobs as home health aides or unlicensed employees at home health agencies or specific healthcare facilities.
6. The bill introduces provisions related to the Women, Infants, and Children Nutrition Program (WIC program), defining "WIC vendor agreement" and outlining sanctions for non-compliance.
7. The state department must select WIC program vendors based on federal criteria, review these criteria annually, include them in the WIC state plan, and publish them on the state department's website.
8. It expands reporting requirements for the release of mental health records without the patient's consent to various child fatality and review teams.
9. The bill addresses food safety by updating terminology related to home-based food products and defining "time temperature control for safety food."
10. It includes the State Health Commissioner or their designee as a member of the Rare Disease Advisory Council and adjusts the quorum requirement for council meetings.
11. Membership changes are made to the Statewide Child Fatality Review Committee, and the expiration of the Maternal Mortality Review Laws is repealed.

Yeas: 11; Nays: 0 

House Bill 1203: POSSESSION OF XYLAZINE (MELTZER,J) - Listing of xylazine as a controlled substance. Makes xylazine a schedule II controlled substance.

BILL HELD.

House Bill 1238: COMPETENCY TO STAND TRIAL (MCNAMARA, W) - Section 1 - Eligibility for Mental Health and Addiction Forensic Treatment Services:

• An individual is eligible for mental health and addiction forensic treatment services if they meet certain criteria, including being a resident of Indiana, being at least 18 years old (or younger with special approval), and entering the criminal justice system as a felon or for competency restoration services.
• Reimbursement for these services should not be available through various sources, including insurance policies, Medicaid, Medicare, or federal assistance programs.
• Grants and vouchers under this chapter may be used to cover the costs that exceed reimbursement from other sources.
• The division is responsible for determining the extent of reimbursement an individual is entitled to receive from other sources.
• The division may operate a pilot program applying the eligibility criteria to individuals charged with misdemeanors.

Competency Determinations:

• If the court has reasonable grounds to believe that a defendant lacks the ability to understand the proceedings and assist in the preparation of a defense, it shall schedule a hearing to determine competency.
• The court shall appoint two or three competent, disinterested individuals with expertise in determining competency to evaluate the defendant.
• Additional individuals may be appointed upon request from either party.
• If the court finds that the defendant lacks competency, the trial shall be delayed or continued, and the defendant shall be committed to the division of mental health and addiction for competency restoration services.
• The division shall provide these services in a location appropriate to the defendant's needs and safety, potentially at a department of correction facility.
• The court shall transmit relevant information to the NICS (National Instant Criminal Background Check System).

Certification of Competency Attainment:

• Within 90 days of a defendant's admission to a state institution or the initiation of competency restoration services by a third-party contractor, the superintendent or director/medical director must certify whether the defendant has a substantial probability of attaining competency.
• Charges may be dismissed without prejudice if the defendant is diagnosed with certain conditions (dementia, Alzheimer's disease, or traumatic brain injury) that impact their ability to understand proceedings and if they are charged with a misdemeanor or Level 6 felony.

Regular Commitment Proceedings:

• If a defendant found to have a substantial probability of attaining competency has not done so within six months or if charges were not dismissed, regular commitment proceedings may be initiated.

Bills heard in the Senate:

Senate Bill 139: PSILOCYBIN TREATMENT PROGRAM (Charbonneau, E) - This bill establishes a program in Indiana known as the "Psilocybin Treatment Program." Here's an explanation of what this bill aims to do:

Psilocybin Research Fund:

• The bill creates a fund called the "Therapeutic Psilocybin Research Fund." This fund will be administered by the Indiana Department of Health (state department).

Research Assistance:

• The primary purpose of this fund is to provide financial assistance to research institutions within Indiana. These institutions will use the funds to conduct studies and research related to the use of psilocybin, a naturally occurring compound found in certain mushrooms, for the treatment of mental health and other medical conditions.

Clinical Study Requirements:

• The bill sets forth specific requirements and guidelines for conducting clinical studies using psilocybin. These studies are expected to be scientific investigations into the therapeutic potential of psilocybin for addressing various medical conditions, particularly mental health issues.

Reporting Obligations:

• Research institutions conducting these clinical studies are required to prepare and submit detailed reports about their findings and research outcomes. These reports must be submitted to the Interim Study Committee on Public Health, Behavioral Health, and Human Services, the Indiana Department of Health, and the Division of Mental Health and Addiction.

This bill establishes a program that supports research into the therapeutic use of psilocybin, particularly for addressing mental health and other medical conditions. It creates a fund to provide financial assistance to research institutions conducting these studies and outlines specific requirements for conducting such clinical research. The goal is to better understand the potential benefits and risks associated with psilocybin and its use as a treatment option in Indiana.

Yeas: 11; Nays: 0

Senate Bill 3: PRIOR AUTHORIZATION  (Johnson, T)

The bill prohibits utilization review entities from requiring prior authorization for medication related to opioid use disorder, which means that individuals seeking medication for opioid use disorder would not need prior authorization to access this treatment. This bill places restrictions on utilization review entities, limiting them to impose prior authorization requirements on less than 1% of specialty or healthcare services and 1% of healthcare providers annually. It also prohibits prior authorization for certain services and drugs, sets requirements for entities that require prior authorization, mandates physician review of adverse determinations and appeals, and provides exemptions if the entity approves 80% of prior authorization requests for a specific healthcare service. Additionally, it repeals outdated prior authorization provisions and makes related adjustments.

Yeas: 10; Nays: 0;

Senate Bill 233: CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS (Crider, M)

This bill mandates that the office of the secretary of family and social services and the division of mental health and addiction must include eligible community mental health centers in either the community mental health services demonstration program, subject to approval, or in a Medicaid state plan amendment or waiver for Medicaid reimbursement for certified community behavioral health clinic services by specific Medicaid providers, in the event Indiana is not approved to participate in the demonstration program.